Veneers can damage your teeth

This article in the Daily Mail caught my eye yesterday. It details some problems patients have run into after having cosmetic veneers placed, specifically the nerves dying and needing rot-canal treatments. It makes quite horrifying reading!

Like all these things we need to look at the whole picture. Veneers are used in different circumstances to improve the appearance of the teeth, by changing the colour, shape or position of the teeth. They are usually thin porcelain laminates glued to the front of the teeth, if you watch "10 years younger" you will know what a transformation to someone's smile they can make.

It is certainly true that they are not without their potential problems. They don't last forever and will need replacing eventually. If the teeth are very irregular then some teeth will need to be reduced in size to ensure the porcelain is not too thick. Taking healthy tooth away for cosmetic purposes is obviously not suitable for everybody.

I often see patients who have rejected the idea of veneers because they do not wish to have otherwise healthy tooth tissue taken away. Orthodontic treatment can often give a similar improvement in appearance without cutting into teeth but it does take longer and obviously involves wearing braces! The picture show veneers which were inappropriately placed on crooked teeth. However, orthodontics is not without potential problems such as damage to the roots and enamel surface and relapse.

If you are considering any cosmetic treatment, whether it be veneers, tooth whitening or orthodontics, then please make sure you spend time talking to your dentist. Make sure they explain the advantages and disadvantages if treatment. If necessary, seek more than one opinion and try to see a specialist, or at least someone who is experienced in this sort of treatment and can show you examples of their work. Many of the dentists I know who do cosmetic treatment will spend several visit planning the treatment with your and will also place temporary veneers or crowns which can be adjusted until you are happy with the appearance.

Don't let this put you off treatment if you are unhappy with your teeth. But do make sure you are fully informed before committing to treatment, whatever it might be.

What's in your mouth?

That was the title of the ITV Tonight programme I have just watched. This was about the "poison" that is dental amalgam (the stuff used for filling teeth) and is a story that crops up every few years. Like previous programmes (I think Panorama did one a few years ago) it is trying to shock and sensationalise, quoting a woman who had all her amalgam fillings replaced and is now miraculously cured of all her health problems.

I was disappointed by the representatives of the dental profession. Peter Ward from the BDA looked a total fool in response to not unreasonable questions. Chief Dental Officer Barry Crockroft seemed woefully underprepared. Surely someone could have found him some decent studies to support the argument for dental amalgam?

OK, how about some of the things that I know about dental amalgam...
1 Mercury is poisonous but in fillings is mixed with other metals. Most mercury is released during placement and removal of fillings, but it is unlikely that the amounts are harmful.
2 Dentists do have to follow regulations regarding the disposal of amalgam to safeguard the environment (otherwise mercury would build up and get into the food-chain, potentially much more damaging).
3 Scandinavian countries have banned amalgam, but in an attempt to reduce the amount in the environment and not due to direct impact on the health of individuals.
4 It is still the best filling material in terms of cost and longevity, although dental material science is advancing all the time and will eventually catch up.
5 There has been advice for a few years to limit placement of amalgam in pregnant women, but no advice on whether pregnant dentists should avoid using it!

Please don't panic about this and immediately rush off to your dentist to get your fillings taken out. By all means, discuss the options with your dentist. In fact, many patients are choosing alternatives to amalgam, but generally for aesthetic reasons. It is also worth looking carefully at the costs involved as the cheaper white filling materials tend not to perform as well as amalgam. Gold or porcelain inlays are an excellent alternative but are more costly, so many patients tend to choose them as old fillings wear out and need replacing anyway.

As for me, I will not be rushing to get my amalgam fillings replaced and would not hesitate to have another if my dentist recommended it.

Oh, and I might consider writing to the presenter of the programme to see if he would like some orthodontics to close the gaps in his teeth...!

Dentistry in the news

I can't really let this week pass without commenting on three stories that have caught my attention and its only Monday so far!

Girl with dentist fear starves to death
An eight-year old girl died in 2005 from starving herself due to a fear of dentists and dental problems. Its a truly shocking story and one which I hope will never be repeated.

What's in your mouth?
I have just watched this TV programme about mercury in dental fillings. There's a lot to say on this so I will comment in a separate blog post.

Dentist accused of murder
I have just returned from a weekend in Northern Ireland where this story is front page news. A dentist and his ex-lover are accused of the murder of their ex-partners. This happened many years ago and was believed to be suicide until recently. The story becomes more sensational with accusations of sexual assaults by former patients and the possibility of a third murder. A "Harold Shipman" of dentistry? You may hear more of this story as talks are already underway to turn it into a film!

Three sensational news stories which do not really do much to promote dentistry in a positive light, but isn't it the case that bad news spreads faster than good news?

DIY Dentistry

Click on the title to read a news story about how millions of people are resorting to DIY efforts to fix their teeth. I am sure many people have tried temporary fixes until they can reach a dentist (I have often seen patients who have stuck a crown back in with glue or chewing gum), but it is horrifying to think that some people are doing this instead of seeing a dentist.

I guess it is partly due to the lack of NHS dentists around and the fact that many dentists have waiting lists even for emergencies. I also know there are still many people who are scared of visiting the dentist, which is a shame because most of the dentists I know are caring professionals who take their time to make their patients comfortable.

Certainly we do still have patients who are nervous or worried, but often it is fear of the unknown and I will always explain honestly what will happen during treatment. I can recall a number of patients, both adults and children, who have been nervous at the start of their orthodontic treatment but relaxed and comfortable by the time the braces are removed.

So if you are putting off that visit to the dentist or orthodontist please don't, book an appointment and you may well be surprised to find it is not as bad as you think.